Chhabra Deepak G, Shah Rajiv C, Parikh Vipul, Jagannath P
Department of Surgical Oncology, Lilavati Hospital and Research Center, Mumbai, India.
Indian J Gastroenterol. 2006 Mar-Apr;25(2):66-70.
Radiofrequency ablation (RFA), a thermal coagulation technique, has been used for ablation of primary and secondary liver tumors.
Over a 24-month period, 41 patients, including 20 with hepatocellular cancer (HCC), 14 with liver metastases from colorectal tumors and 7 with metastases from other tumors, underwent RFA in our institution. Ablation was done using intra-operative (n=27) or percutaneous ultrasonographic (n=14) guidance. A zone of ablation larger than the size of the lesion on CT scan indicated successful RFA.
The mean size of lesions was 4.9 cm for HCC and 3.1 cm for metastases. Among 20 patients with HCC, 16 had complete tumor ablation and one had failure of localization. All patients with liver metastases had successful tumor ablation. There was no procedure-related death. Two patients had hemoperitoneum and one experienced skin burn. During a median follow up of 16 months, five patients with HCC and two with colorectal metastases died. One patient had tumor recurrence at the ablation site and two developed fresh solitary metastatic lesions; all three are disease-free after repeat ablation treatment.
RFA is a safe and promising technique for the treatment of non-resectable HCC and liver metastases, in the short term.
射频消融(RFA)是一种热凝固技术,已用于原发性和继发性肝肿瘤的消融治疗。
在24个月的时间里,41例患者在我们机构接受了RFA治疗,其中包括20例肝细胞癌(HCC)患者、14例结直肠肿瘤肝转移患者和7例其他肿瘤转移患者。消融采用术中引导(n = 27)或经皮超声引导(n = 14)。CT扫描显示消融区大于病灶大小表明RFA成功。
HCC病灶的平均大小为4.9 cm,转移灶为3.1 cm。20例HCC患者中,16例肿瘤完全消融,1例定位失败。所有肝转移患者的肿瘤均成功消融。无手术相关死亡。2例患者发生血腹,1例出现皮肤烧伤。中位随访期为16个月,5例HCC患者和2例结直肠转移患者死亡。1例患者在消融部位出现肿瘤复发,2例出现新的孤立性转移病灶;这3例患者在重复消融治疗后均无疾病进展。
短期内,RFA是治疗不可切除HCC和肝转移的一种安全且有前景的技术。